一项关于小儿神经外科坏消息告知培训项目的长期评估：一项试点研究。

A long-term evaluation of a training program on breaking bad news in pediatric neurosurgery: a pilot study.

作者信息

Zanello Marc, Baugnon Thomas, Roux Alexandre, Di Rocco Federico

机构信息

1Department of Neurosurgery, Sainte-Anne Hospital, Paris.

2Sorbonne Paris Cité, Paris Descartes University, Paris.

出版信息

J Neurosurg Pediatr. 2020 Mar 13;25(6):670-678. doi: 10.3171/2019.12.PEDS19554. Print 2020 Jun 1.

DOI:10.3171/2019.12.PEDS19554

PMID:32168486

Abstract

OBJECTIVE

Breaking bad news is a difficult task in medical practice. Several breaking-bad-news training programs have been proposed. However, long-term results of such training have rarely been investigated. The aim of this study was to compare the short- and long-term evaluations by young neurosurgeons of a training program for breaking bad news to patients and their parents.

METHODS

Between 2012 and 2015, pediatric neurosurgery residents participated in a training day on breaking bad news in pediatric neurosurgery with professional actors. A personal debriefing, followed by a theoretical session, completed the training. Immediate feedback was evaluated through a survey administered at the end of the day. Long-term results were explored via an online form sent at least 3 years after the training completion.

RESULTS

Seventeen participants from 9 different countries were interviewed. Their immediate feedback confirmed their interest. For 71% of them, the program was very interesting, and 77% were extremely satisfied or very satisfied. All trainees wanted more training sessions. At a mean of 4.5 years of follow-up (range 3-6 years), 71% of the trainees fully remembered the session. Most of them (86%) reported a positive impact of the training on their career. Only 21% had another training session on breaking bad news during their residency. At long-term analysis, fewer trainees considered the duration of the training to have been sufficient (p = 0.044).

CONCLUSIONS

Breaking-bad-news training has a positive long-term educational impact even several years later. Such a training program should be implemented into pediatric neurosurgery residency.

摘要

目的

在医疗实践中，传达坏消息是一项艰巨的任务。已经提出了几种传达坏消息的培训方案。然而，此类培训的长期效果鲜有研究。本研究的目的是比较年轻神经外科医生对向患者及其家长传达坏消息的培训方案的短期和长期评价。

方法

2012年至2015年期间，儿科神经外科住院医师参加了由专业演员参与的儿科神经外科坏消息传达培训日活动。培训以个人汇报开始，随后是理论课程。通过当天结束时进行的一项调查评估即时反馈。通过在培训结束至少3年后发送的在线表格探索长期效果。

结果

对来自9个不同国家的17名参与者进行了访谈。他们的即时反馈证实了他们的兴趣。其中71%的人认为该方案非常有趣，77%的人极其满意或非常满意。所有学员都希望有更多的培训课程。平均随访4.5年（范围3 - 6年），71%的学员完全记得该课程。他们中的大多数人（86%）报告称培训对他们的职业生涯有积极影响。在住院期间，只有21%的人参加了另一项关于传达坏消息的培训课程。在长期分析中，较少的学员认为培训时长足够（p = 0.044）。